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“Never Events”

Researchers at Johns Hopkins say that despite efforts to improve surgical safety, 4,044 so-called "never events," including leaving a foreign object such as a sponge inside a patient’s body, occur in the U.S. each year. Laura Landro reports on The News Hub.

They are known as "never events"—the kind of mistake that should never happen in medicine, like operating on the wrong patient or sewing someone up with a sponge still inside—yet new research suggests that they happen with alarming frequency.

Surgeons make such mistakes more than 4,000 times a year in the U.S., according to a study led by Johns Hopkins University School of Medicine, published online in the journal Surgery. The study, using data in the National Practitioner Data Bank, a federal repository of medical-malpractice judgments and out-of-court settlements, looked at cases involving leaving an object inside a patient, wrong-site surgeries, wrong procedures and wrong-patient surgeries.

Avoidable Mistakes

Researchers identified 9,744 malpractice payments tied to surgical ‘never events’ between September 1990 and September 2010. A breakdown:

Foreign object left behind 49.8%

Wrong procedure 25.1%

Wrong site 24.8%

Wrong patient 0.3%

Between 1990 and 2010, malpractice payments for such ‘never events’ reported to a database totaled $1.3 billion.

The mean payment was$133,055.

Wrong procedures were the costliest ‘never events,’ with a median payment of $106,777.

The lowest payouts were for foreign objects left behind, with a median payment of$33,953.

Source: Johns Hopkins

In the 9,744 cases identified between 1990 and 2010, just over 6% of patients died, 32.9% had permanent injury and 59.2% suffered temporary injury, according to the researchers. Based on the number of paid claims and a prior study that estimated that only 12% of surgical adverse events result in indemnity payments, the researchers arrived at an estimate that at least 4,082 mistakes actually occur in the U.S. each year.

Typically, they are found only when a patient experiences a complication after surgery, such as an infection, and efforts are made to find out why, he said. As many as one in three or four retained sponges may never be discovered. Dr. Makary said, but that may be in part because hospitals can decide not to name individual doctor on settlements under some circumstances, and thus not report to the practitioner database.

A version of this article appeared December 20, 2012, on page A2 in the U.S. edition of The Wall Street Journal, with the headline: Surgeons Make Thousands of Errors.

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